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dale needham

Carol L Hodgson, Alison E Turnbull, Theodore J Iwashyna, Ann Parker, Wesley Davis, Clifton O Bingham, Nicola R Watts, Simon Finfer, Dale M Needham
BACKGROUND: There is increasing interest in measuring the quality of survivorship for patients admitted to the intensive care (ICU) for acute respiratory failure (ARF). However, there is substantial variability in the patient outcomes reported in studies evaluating these patients, with few data on which outcomes are essential to inform clinical practice. PURPOSE: To determine clinicians' perspectives on the outcome domains that should always be reported in studies evaluating ARF survivors after hospital discharge, and to compare findings between the US and Australian perspectives...
October 6, 2016: Physical Therapy
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Robert K Lord, Victor D Dinglas, Alexandra Chong, Kristin A Sepulveda, Pedro A Mendez-Tellez, Carl B Shanholtz, Donald M Steinwachs, Peter J Pronovost, Dale M Needham
OBJECTIVE: To evaluate the time-varying relationship of annual physical, psychiatric, and quality of life status with subsequent inpatient healthcare resource use and estimated costs. DESIGN: Five-year longitudinal cohort study. SETTING: Thirteen ICUs at four teaching hospitals. PATIENTS: One hundred thirty-eight patients surviving greater than or equal to 2 years after acute respiratory distress syndrome. INTERVENTIONS: None...
September 29, 2016: Critical Care Medicine
Sarah Elizabeth Jolley, Marc Moss, Dale M Needham, Ellen Caldwell, Peter E Morris, Russell R Miller, Nancy Ringwood, Megan Anders, Karen K Koo, Stephanie E Gundel, Selina M Parry, Catherine L Hough
OBJECTIVE: Early mobility in mechanically ventilated patients is safe, feasible, and may improve functional outcomes. We sought to determine the prevalence and character of mobility for ICU patients with acute respiratory failure in U.S. ICUs. DESIGN: Two-day cross-sectional point prevalence study. SETTING: Forty-two ICUs across 17 Acute Respiratory Distress Syndrome Network hospitals. PATIENTS: Adult patients (≥ 18 yr old) with acute respiratory failure requiring mechanical ventilation...
September 22, 2016: Critical Care Medicine
Kitty S Chan, Lisa Aronson Friedman, O Joseph Bienvenu, Victor D Dinglas, Brian H Cuthbertson, Richard Porter, Christina Jones, Ramona O Hopkins, Dale M Needham
OBJECTIVE: This study will estimate distribution-based minimal important difference (MID) for the Hospital Anxiety and Depression Scale anxiety (HADS-A) and depression (HADS-D) subscales, and the Impact of Event Scale-Revised (IES-R) in survivors of acute respiratory failure (ARF). METHODS: Secondary analyses of data from two US and three UK studies of ARF survivors (total N=1223). HADS-D and HADS-A were used to assess depression and anxiety symptoms. IES-R assessed post-traumatic stress disorder symptoms...
September 2016: General Hospital Psychiatry
Elizabeth R Pfoh, Amy W Wozniak, Elizabeth Colantuoni, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Nancy D Ciesla, Peter J Pronovost, Dale M Needham
PURPOSE: Survivors of acute respiratory distress syndrome (ARDS) are at high risk for new or ongoing physical declines after hospital discharge. The objective of our study was to evaluate the epidemiology of physical declines over 5-year follow-up and identify patients at risk for decline. METHODS: This multi-site prospective cohort study evaluated ARDS survivors who completed a physical status assessment at 3 or 6 months post-discharge. Three measures were evaluated: muscle strength (Medical Resource Council sumscore); exercise capacity [6-min walk test (6MWT)]; physical functioning [36-Item Short Form Health Survey (SF-36 survey)]...
October 2016: Intensive Care Medicine
Alison E Turnbull, Sarina K Sahetya, Dale M Needham
OBJECTIVE: To develop a list of non-emergent, potentially harmful interventions commonly performed in ICUs that require a clear understanding of patients' treatment goals. BACKGROUND: A 2016 policy statement from the American Thoracic Society and American College of Critical Care Medicine calls on intensivists to engage in shared decision-making when "making major treatment decisions that may be affected by personal values, goals, and preferences." METHODS: A three-round modified Delphi consensus process was conducted via a panel of 6 critical care physicians, 6 ICU nurses, 6 former ICU patients, and 6 family members from 6 academic and community-based medical institutions in the U...
September 1, 2016: Heart & Lung: the Journal of Critical Care
Linda Denehy, Julie Lanphere, Dale M Needham
No abstract text is available yet for this article.
August 25, 2016: Intensive Care Medicine
Minxuan Huang, Kitty S Chan, Jennifer M Zanni, Selina M Parry, Saint-Clair G B Neto, Jose A A Neto, Vinicius Z M da Silva, Michelle E Kho, Dale M Needham
OBJECTIVES: To evaluate the internal consistency, validity, responsiveness, and minimal important difference of the Functional Status Score for the ICU, a physical function measure designed for the ICU. DESIGN: Clinimetric analysis. SETTINGS: Five international datasets from the United States, Australia, and Brazil. PATIENTS: Eight hundred nineteen ICU patients. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: Clinimetric analyses were initially conducted separately for each data source and time point to examine generalizability of findings, with pooled analyses performed thereafter to increase power of analyses...
August 3, 2016: Critical Care Medicine
Samuel M Brown, Emily Wilson, Angela P Presson, Chong Zhang, Victor D Dinglas, Tom Greene, Ramona O Hopkins, Dale M Needham
BACKGROUND: With improving short-term mortality in acute respiratory distress syndrome (ARDS), understanding and improving quality of life (QOL) outcomes in ARDS survivors is a clinical and research priority. We sought to identify variables associated with QOL, as measured by the EQ-5D health utility score, after ARDS using contemporary data science methods. METHODS: Analysis of prospectively acquired baseline variables and 6-month EQ-5D health utility scores for adults with ARDS enrolled in the ARDS Network Long-Term Outcomes Study (ALTOS)...
July 20, 2016: Thorax
Swaroopa R Nalamalapu, Dale M Needham, Renee D Stapleton
No abstract text is available yet for this article.
July 2016: Critical Care Medicine
Alison E Turnbull, Wesley E Davis, Dale M Needham, Douglas B White, Michelle N Eakin
RATIONALE: Intensive care unit (ICU) patients' expected post-discharge outcomes are rarely discussed in family meetings despite this information being centrally important to patients and their families. OBJECTIVES: To characterize intensivist-identified barriers and facilitators to discussing post-discharge outcomes with surrogates of ICU patients. METHODS: Qualitative study conducted via one-on-one, semistructured telephone interviews with 23 intensivists from 20 hospitals with accreditation council for graduate medical education-accredited critical care medicine programs in 16 states...
September 2016: Annals of the American Thoracic Society
Amy L Toonstra, Archana Nelliot, Lisa Aronson Friedman, Jennifer M Zanni, Carol Hodgson, Dale M Needham
PURPOSE: Knowledge-related barriers to safely implement early rehabilitation programs in intensive care units (ICUs) may be overcome via targeted education. The purpose of this study was to evaluate the effectiveness of an interactive educational session on short-term knowledge of clinical decision-making for safe rehabilitation of patients in ICUs. METHOD: A case-based teaching approach, drawing from published safety recommendations for initiation of rehabilitation in ICUs, was used with a multidisciplinary audience...
June 13, 2016: Disability and Rehabilitation
Elizabeth Colantuoni, Victor D Dinglas, E Wesley Ely, Ramona O Hopkins, Dale M Needham
No abstract text is available yet for this article.
July 2016: Lancet Respiratory Medicine
Anahita Rabiee, Sina Nikayin, Mohamed D Hashem, Minxuan Huang, Victor D Dinglas, O Joseph Bienvenu, Alison E Turnbull, Dale M Needham
OBJECTIVES: To synthesize data on prevalence, natural history, risk factors, and post-ICU interventions for depressive symptoms in ICU survivors. DATA SOURCES: PubMed, EMBASE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and Cochrane Controlled Trials Registry (1970-2015). STUDY SELECTION: Studies measuring depression after hospital discharge using a validated instrument in more than 20 adults from non-specialty ICUs...
September 2016: Critical Care Medicine
Rolf Dubb, Peter Nydahl, Carsten Hermes, Norbert Schwabbauer, Amy Toonstra, Ann M Parker, Arnold Kaltwasser, Dale M Needham
Early mobilization of patients in the intensive care unit (ICU) is safe, feasible, and beneficial. However, implementation of early mobility as part of routine clinical care can be challenging. The objective of this review is to identify barriers to early mobilization and discuss strategies to overcome such barriers. Based on a literature search, we synthesize data from 40 studies reporting 28 unique barriers to early mobility, of which 14 (50%) were patient-related, 5 (18%) structural, 5 (18%) ICU cultural, and 4 (14%) process-related barriers...
May 2016: Annals of the American Thoracic Society
Elizabeth R Pfoh, Kitty S Chan, Victor D Dinglas, Brian H Cuthbertson, Doug Elliott, Richard Porter, O Joseph Bienvenu, Ramona O Hopkins, Dale M Needham
RATIONALE: Survivors of acute respiratory failure commonly experience long-term psychological sequelae and impaired quality of life. For researchers interested in general mental health, using multiple condition-specific instruments may be unnecessary and inefficient when using the Medical Outcomes Study Short Form (SF)-36, a recommended outcome measure, may suffice. However, relationships between the SF-36 scores and commonly used measures of psychological symptoms in acute survivors of respiratory failure are unknown...
August 2016: Annals of the American Thoracic Society
Mohamed D Hashem, Archana Nelliot, Dale M Needham
Despite the historical precedent of mobilizing critically ill patients, bed rest is common practice in ICUs worldwide, especially for mechanically ventilated patients. ICU-acquired weakness is an increasingly recognized problem, with sequelae that may last for months and years following ICU discharge. The combination of critical illness and bed rest results in substantial muscle wasting during an ICU stay. When initiated shortly after the start of mechanical ventilation, mobilization and rehabilitation can play an important role in decreasing the duration of mechanical ventilation and hospital stay and improving patients' return to functional independence...
July 2016: Respiratory Care
Claire J Tipping, Michael J Bailey, Rinaldo Bellomo, Susan Berney, Heidi Buhr, Linda Denehy, Meg Harrold, Anne Holland, Alisa M Higgins, Theodore J Iwashyna, Dale Needham, Jeff Presneill, Manoj Saxena, Elizabeth H Skinner, Steve Webb, Paul Young, Jennifer Zanni, Carol L Hodgson
RATIONALE: The ICU Mobility Scale (IMS) is a measure of mobility milestones in critically ill patients. OBJECTIVES: This study aimed to determine the validity and responsiveness of the IMS from a prospective cohort study of adults admitted to the intensive care unit (ICU). METHODS: Construct and predictive validity were assessed by comparing IMS values at ICU discharge in 192 patients to other variables using Spearman rank correlation coefficient, Mann-Whitney U tests, and logistic regression...
June 2016: Annals of the American Thoracic Society
Karin J Neufeld, Jirong Yue, Thomas N Robinson, Sharon K Inouye, Dale M Needham
OBJECTIVES: To evaluate the effectiveness of antipsychotic medications in preventing and treating delirium. DESIGN: Systematic review and meta-analysis. SETTING: PubMed, EMBASE, CINAHL, and databases were searched from January 1, 1988, to November 26, 2013. PARTICIPANTS: Adult surgical and medical inpatients. INTERVENTION: Antipsychotic administration for delirium prevention or treatment in randomized controlled trials or cohort studies...
April 2016: Journal of the American Geriatrics Society
Mohamed D Hashem, Ann M Parker, Dale M Needham
Neuromuscular disorders are increasingly recognized as a cause of both short- and long-term physical morbidity in survivors of critical illness. This recognition has given rise to research aimed at better understanding the risk factors and mechanisms associated with neuromuscular dysfunction and physical impairment associated with critical illness, as well as possible interventions to prevent or treat these issues. Among potential risk factors, bed rest is an important modifiable risk factor. Early mobilization and rehabilitation of patients who are critically ill may help prevent or mitigate the sequelae of bed rest and improve patient outcomes...
September 2016: Chest
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